Day: 26 July 2021

Can Anything Save the NHS?

The Daily Sceptic’s in-house doctor – formerly employed by the NHS, now in private practice – has written a guest post about a recent Policy Exchange report on how the NHS should manage its huge waiting list. He isn’t impressed.

Last week, the think tank Policy Exchange published a report entitled: “A wait on your mind – a realistic proposal for tackling the elective backlog.”

I’m very grateful to the authors, because I love a good chuckle, and this banal document had me laughing out loud at several points. There is so much in it, I barely know where to start – this article can only scratch the surface. It commits the cardinal sin of most NHS ‘strategy documents’ effectively being a wish list for a healthcare utopia – oblivious to the obvious fact that in a world of limited resources, one cannot be strong everywhere.

Readers may not be aware of how or why such reports are constructed. As with all medical/scientific publishing, it’s important to understand the process of production to uncover the real purpose and message. I have contributed to several similar documents over the years. The starting point is normally a specific agenda that the report’s funders wish to push – this isn’t always obvious, although an informed audience can read between the lines. I note that this report was “supported by research grants provided by Ramsay Health Care UK, Smith + Nephew and the Independent Healthcare Provider Network (IHPN)”. Readers can probably figure out the agenda for themselves.

The ‘evidence’ for the report is generally acquired by selecting a compliant group of ‘experts’ that can be relied on to provide the correct opinions. The experts are gathered together with plenty of tea and biscuits – or a couple of cases of wine for a more revealing discussion.

Once the experts have sounded off from their particular perspectives, the writers craft the comments into a narrative. The language is usually verbose in style containing pages of pointless verbiage calculated to dress up the work as deeply researched and referenced. On closer inspection many of the ‘references’ are linked to other opinion pieces that conveniently chime with the predetermined purpose. Reliable ‘elder statesmen’ write a preface and a forward to create an illusion of gravitas and authority. Various other lesser figures in prominent medico-political positions are co-opted for endorsements.

The report is then touted around decision makers and passed off as a representation of current thinking. Successful documents provide decision makers with intellectual cover for controversial changes they want to make anyway. In some ways it’s a bit like employing management consultants – they are paid to tell policy makers what they want to hear, and to take the blame if the decision goes sour.

Do the U.K.’s Falling Case Numbers Prove Lockdowns Don’t Work?

I’ve written a piece for Mail+ today asking whether the rapid decline in daily cases since ‘Freedom Day’ suggests that lockdowns don’t work. Here’s the kernel of the argument.

For critics of the lockdown policy like me, this is beginning to look like vindication. We have long argued that the ebb and flow of the virus isn’t affected by state interventions, pointing out that cases seem to rise and fall in the same wave-like patterns across similar regions, irrespective of the action taken by different leaders.

For instance, the states of California and Florida share a number of characteristics, but their governors have taken very different approaches to managing the virus. Gavin Newsom, the democratic governor of California, has imposed some of the most severe restrictions in the United States, while Ron DeSantis, the republican governor of Florida, has imposed some of the lightest. Yet the number of Covid deaths in each state are almost identical – 163 per 100,000 in California and 179 per 100,000 in Florida.

Lockdown advocates claim that the UK’s lockdowns prove the policy is effective, with cases only starting to decline after they were rolled out. But Simon Wood, a professor of statistics at Edinburgh University, has analysed the impact of our lockdowns in detail and found that in all three cases infections had begun to fall before they were imposed, e.g. the UK’s third lockdown was put in place on January 6, but cases peaked at the end of December.

Prof Wood’s analysis, as well as the data from other countries, suggests that an infection wave will start to decline in the absence of top-down restrictions, and that has been confirmed by the steady fall in daily cases since ‘Freedom Day’. The reason that’s significant is because it implies that the eye-watering financial cost of the lockdowns – £250 billion and counting – has been unnecessary, not to mention the missed hospital appointments, school closures, and terrible toll on the nation’s mental health.

Worth reading in full.

I think it’s probably too early to start gloating, but it does look as though the gloomsters on SAGE – not to mention the doomsters on Independent SAGE – got the modelling badly wrong. According to the latest data, the number of new cases today stands at 24,950, the sixth consecutive fall in as many days.

Lockdown zealots will attribute this decline to the vaccines, but that begs the question of why they weren’t confident the vaccines would prevent cases from surging when they predicted armageddon last Monday? No doubt vaccines have played a part, but so has natural immunity (by catching the disease and recovering) and pre-existing immunity (by having caught and recovered from a similar disease in the past). And we shouldn’t exaggerate the part the vaccines have played because we now know the trial data over-estimated how efficacious vaccines are against infection. The evidence that they significantly reduce the risk of serious disease and death is still robust; but evidence that they significantly reduce the risk of infection or transmission isn’t holding up very well, which is one reason vaccine passports are a waste of time.

Even though it’s too soon for lockdown sceptics to declare victory, we can at least start thinking about which of the zealots to start ridiculing – and with that in mind, it’s worth revisiting Neil Ferguson’s appearance on the Andrew Marr Show on July 18th.

Among Professor Lockdown’s claims were:

  • It was “almost inevitable” that daily cases would climb to 100,000 a day and hospital admissions to 1,000 a day following the easing of restrictions.
  • It was distinctly possible that daily cases would climb to 200,000 a day and hospital admissions to 2,000 a day, which would cause “major disruption” to the NHS.
  • The peak of the current wave could occur between August and mid-September.
  • “It’s going to be a difficult summer for many reasons.”

Young People Are Abandoning Masks

To judge from the opinion polls, you’d think young people are wildly enthusiastic about all the coronavirus restrictions, with 57% of 18 to 25 year-olds being in favour of the introduction of vaccine passports as a condition of entry for nightclubs, according to YouGov. But a new YouGov poll suggests otherwise. MailOnline has more.

The survey found 46% of 18 to 24 year-olds said they wore a face mask in a public place in the last two weeks, compared to 58% on July 16th and 64% on June 2nd.

Meanwhile, the survey of 1,742 British adults between July 21st and 22nd found other age groups were still wearing face coverings at around the same rate.

Data shows 69% of all Britons say they wore a face mask in the last two weeks, compared to 71% on July 16th and 73% on June 2nd.

YouGov also said young people were less likely to be fully vaccinated and more likely to have disabled their NHS COVID-19 app.

The researcher said that while last week 38% of 18 to 24 year-olds had been avoiding crowded places, this has now fallen to 26%.

Worth reading in full.

Ireland Will Finally Distinguish Between Hospital Patients Actually Ill From Covid and Those Who Simply Test Positive

The Irish Government has announced that it will change the way it collects data on Covid hospitalisations by distinguishing between those who are admitted to hospital because of the virus and those who test positive after being admitted for other reasons. It’s only taken them 17 months! RTÉ has the story.

At present, the Health Service Executive [HSE] Covid hub website states that there are 141 people in hospital who have tested positive for Covid, of whom 22 are in ICU.

A Government spokesperson said it is “seeking better data on hospitalisations in order to better inform decision making.

“This includes details on the total number of positive cases in hospital, the number who contracted Covid while in hospital, and those being treated for Covid specifically.”

RTÉ has also requested this information from the HSE but no data has been forthcoming.

The Government spokesperson added: “Details are also being sought on how many travel-related cases had been fully vaccinated.

“The matter will be discussed further with the National Public Health Emergency Team.”

Last week, HSE Chief Clinical Officer Dr Colm Henry said the “great majority of [Covid patients are in hospital] because they are sick with Covid.

“In some cases there are outbreaks, and in those outbreaks people have been picked up who either who didn’t have symptoms, or very mild symptoms.”

However, Tony Canavan, CEO of the Saolta Hospital Group, told RTÉ’s Morning Ireland last week that “nearly all the [coronavirus] cases” in the group’s hospitals “are being admitted for other reasons” than Covid.

Of those that do test positive for the disease, “the majority are exhibiting mild or moderate symptoms”.

Worth reading in full.

Caroline Lucas MP Says “Cases Are Soaring”. Hasn’t She Seen the Data?

A reader has forwarded an email sent by Green Party MP Caroline Lucas via the platform of March for Change in which she reiterates the need for an immediate public inquiry into the Government’s handling of Covid. As with most people calling for a Covid inquiry, she accused Boris Johnson of lifting the coronavirus restrictions “too soon”. That restrictions suppress infections is simply taken for granted.

The odd thing about this email is that it appears to have been written a week ago since it makes no reference to the fact that the number of daily cases yesterday was 40% lower than it was on July 18th, the day before ‘Freedom Day’. By going ahead with ‘Freedom Day’, Caroline Lucas claims, the Prime Minister has “chosen to bury his head in the sand and simply hope for the best”. As a result of this criminal recklessness, “the third wave of Covid [is] sweep[ing] across the country”, she says, and”cases are soaring”.

In fact, official figures show that cases are falling or levelling off in every region of England, including Caroline Lucas’s Brighton constituency. As Will Jones has pointed out, “the myth of the exit wave persists” – and the fact that this myth is so impervious to facts makes it look like a pro-Lockdown conspiracy theory.

The same goes for Lucas’s claim that hospitals are filling up (see orange line in graph below).

Professor Adam Finn of the Joint Committee on Vaccination and Immunisation says the fall in reported Covid cases “means less viral transmission and eventually fewer hospitalisations and deaths than we feared and expected a week ago”. The biggest problem faced by the NHS is the huge backlog of patients who haven’t received treatment because of successive lockdowns. Not to mention those whose illnesses haven’t even been diagnosed. Isn’t Caroline Lucas concerned that sending out emails like this, including false claims about the case rate, will discourage even more sick people to seek much-needed hospital treatment?

Next time Lucas accuses a lockdown sceptic of trafficking in ‘misinformation’, they should point to this dangerously misleading email.

Stop Press: U.K.’s Covid cases have dropped for the sixth day in a row, according to MailOnline.

Stop Press 2: The Director of March For Change has tweeted an apology to Caroline Lucas for sending out an out-of-date, earlier draft of an email in her name. This is almost certainly a result of our eagle-eyed reader bringing this matter to our attention, the above article and those other Daily Sceptic readers who emailed Caroline Lucas’s office to point out the mistake.

As Infections Plummet Following ‘Freedom Day’ the Models Predicting Catastrophe are Exposed as Fatally Flawed

As reported positive cases plummet following ‘Freedom Day’ – down to 24,950 across the U.K. on Monday, less than half the peak of 54,674 just nine days earlier – the damage limitation among the doomsters begins.

In the Spectator , Professor Oliver Johnson of Bristol University stepped up this morning to try to explain.

He starts by observing that “for the first time in 18 months, there’s been a fall in cases that can’t be easily explained by a national lockdown”. Yet the Spectator recently published an article by Professor Simon Wood showing that new infections peaked and fell before lockdown on all three occasions in England. Did the editors forget to bring it to Professor Johnson’s attention?

Next, Professor Johnson offers some reasons why it may yet be a false dawn.

Indeed it’s possible that the peak in cases, welcome though it is, could only be a local maximum with further rises to come. The rapid reversal in trajectory (from 40% increases between corresponding days of the week to 40% decreases) seems too sudden to be caused by a rapid gain in immunity. It seems more likely to be due to changes in behaviour, with school holidays, the end of the European Championship football and recent hot weather meaning that infected people have had fewer opportunities to spread the disease.

You could have made a similar argument about Covid peaking in Bolton, one of the first places hit by the Delta variant. There was plenty of talk of local herd immunity there. But it’s worth noticing that those falls were subsequently reversed.

And here’s the risk now: what behaviour gives, behaviour can take away. I don’t think anyone can be certain if and when Covid might start going up again. But Scotland gives us hope that sustained falls may be possible.

So far we haven’t even seen the effect of the July 19th reopening in the data, let alone people following now-deleted advice not to ‘cower’, plus there’s the return to schools and universities to come, seasonal effects coming back in the autumn and so on.

The argument that “what behaviour gives, behaviour can take away” is precisely why the models always predict exit waves. Yet the modellers don’t seem to have noticed that these exit waves never happen. There was no exit wave in the U.K. or Europe in summer 2020, nor in spring 2021 in the U.K. as restrictions were eased, nor in the U.S. as measures were lifted. Yet the myth of the exit wave persists.

Minister Confirms Government Not Ruling Out Barring University Students From Lectures and Halls

The Prime Minister is “raging” about the lower Covid vaccine uptake among young people, and is considering barring university students who don’t get ‘jabbed’ (or who only receive one dose) from attending lectures and living in halls of residence as punishment.

As the number of places unvaccinated Brits could be refused entry to later this year continues to grow, Education Minister Vicky Ford has refused to rule out plans to segregate students based on their vaccination status, after first appearing to deny them. Sky News has the story.

“We aren’t ruling it out,” a senior Government source told Sky News about the prospect of mandating Covid vaccination passports for universities.

According to a report in the Times, Boris Johnson is said to be “pushing” the idea. …

But asked by Kay Burley on Sky News if students would need to be fully vaccinated to enjoy a normal university experience, Education Minister Vicky Ford replied: “No. We must make sure we continue to prioritise education.”

Ms Ford did say that having two jabs would “minimise disruption” for students as they would then not have to isolate if they are identified as a close contact of someone who has tested positive for the virus.

But the minister later appeared to contradict herself, telling BBC Radio 4’s Today programme that ministers will “look at every practicality to make sure that we can get students back safely and make sure that we can continue to prioritise education”.

And she told Times Radio: “We don’t want to go back to a situation where large parts of education were closed to many young people and children, and a key part of doing that is having that double-vaccinated population.

“So I think we need to continue to encourage our young people to step forward, have the vaccination, and that is the way that they can have that freedom and confidence that they’ll be able to have that full university life.”

Speaking in the Commons last week, vaccines minister Nadhim Zahawi said vaccine passports could be introduced for sporting and business events, music venues and festivals in addition to nightclubs.

But he told MPs that individuals will not have to prove their Covid status – full vaccination, a recent negative test or evidence of natural immunity after recovering from the virus – to access schools and universities. [He did, however, also previously ‘rule out’ the introduction of vaccine passports altogether.] …

A minister also did not explicitly rule out the prospect of the Government requiring vaccine passports for people to go to pubs when quizzed by Sky News.

Worth reading in full.

Stop Press: Contradictory reports from Paul Waugh – saying Vicky Ford refused to rule out vaccine checks at universities – and from a Sky News correspondent – saying she did rule them out – highlight the confusion on the matter.

Has the Government Been Undermining Social Norms by Imposing Inconvenient Rules It Cannot Enforce?

Since the start of the pandemic, the Government has introduced a plethora of rules concerning when we can and cannot leave our homes.

Anyone with symptoms is meant to self-isolate at home. Ditto for anyone who tests positive or who comes into contact with someone who’s tested positive. People travelling to Britain from overseas must self-isolate too (except football VIPs). And during the lockdown last year, we weren’t supposed to leave our homes for any reason other than work, exercise or food shopping.

Needless to say, these rules have made life difficult for a lot of people – particularly those who travel regularly, or who manage a small business. The current ‘pingdemic’ is wreaking havoc on Britain’s economy, as service-providers struggle to meet demand for lack of staff.

While asking symptomatic people to self-isolate arguably makes sense, it’s less clear whether all the other rules and regulations can be justified. In a 2019 report on pandemic influenza, the WHO recommended things such as ventilation of indoor spaces and isolation of symptomatic individuals. However, it classified “quarantine of exposed individuals” as “not recommended in any circumstances”.

Aside from the considerable inconvenience they cause, there’s another potential downside of the lockdown rules. Because they’re so difficult to enforce, large numbers of people are simply ignoring them. And might this, in turn, be undermining general norms of law-abidingness?

A major study published in The BMJ back in March found that only 43% of symptomatic people fully adhered to self-isolation – and that was based on data from last year, when the disease was seen as much more of a threat. It’s likely that a similar or even lower percentage of people have been complying with all the other rules.

Why does this matter? Studies have shown that when people observe norms being violated, they become more likely to violate norms themselves, leading to the gradual erosion of norm compliance. For example, a 2008 paper found that people were more likely to litter when there was graffiti next to a “No graffiti” sign than when there were no obvious signs of norm violation.

Regarding the pandemic itself, there’s already evidence that the scandal surrounding Dominic Cummings’ trip to Barnard Castle had a negative effect on adherence to lockdown rules. People reasoned, “If he’s not following the rules, then why should I?”

But the effect might be even more general than that. After witnessing so many examples of lockdown violations over the past year and a half, might people have become more likely to break other rules in society as well? I’m not aware of any evidence of this at the present time, but it doesn’t seem at all implausible.

Of course, one might say: even if the lockdown rules have slightly undermined law-abidingness, they were worth it to control the epidemic. Given the lack of evidence on stay-at-home orders, I am rather doubtful of this. But at the very least, there’s yet another potential cost of lockdown for us to consider.

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